0001415889-19-001011.txt : 20190911
0001415889-19-001011.hdr.sgml : 20190911
20190911174618
ACCESSION NUMBER: 0001415889-19-001011
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190909
FILED AS OF DATE: 20190911
DATE AS OF CHANGE: 20190911
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Giles Richard B
CENTRAL INDEX KEY: 0001525268
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35182
FILM NUMBER: 191089131
MAIL ADDRESS:
STREET 1: 5445 DTC PARKWAY
STREET 2: SUITE 925
CITY: GREENWOOD VILLAGE
STATE: CO
ZIP: 80111
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ampio Pharmaceuticals, Inc.
CENTRAL INDEX KEY: 0001411906
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 260179592
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 373 INVERNESS PARKWAY
STREET 2: SUITE 200
CITY: ENGLEWOOD
STATE: CO
ZIP: 80112
BUSINESS PHONE: 720-437-6500
MAIL ADDRESS:
STREET 1: 373 INVERNESS PARKWAY
STREET 2: SUITE 200
CITY: ENGLEWOOD
STATE: CO
ZIP: 80112
FORMER COMPANY:
FORMER CONFORMED NAME: Chay Enterprises, Inc.
DATE OF NAME CHANGE: 20070910
4
1
form4-09112019_020905.xml
X0306
4
2019-09-09
0001411906
Ampio Pharmaceuticals, Inc.
AMPE
0001525268
Giles Richard B
C/O AMPIO PHARMACEUTICALS, INC.
373 INVERNESS PARKWAY, SUITE 200
ENGLEWOOD
CO
80112
true
false
false
false
Stock Option (Right to Buy)
2.50
2011-03-31
4
D
0
150000
0
D
2021-03-31
Common Stock
150000
0
D
Stock Option (Right to Buy)
2.76
2012-05-07
4
D
0
100000
0
D
2022-05-07
Common Stock
100000
0
D
Stock Option (Right to Buy)
3.95
2013-03-07
4
D
0
80000
0
D
2023-03-07
Common Stock
80000
0
D
Stock Option (Right to Buy)
6.96
2014-06-08
4
D
0
70000
0
D
2024-06-08
Common Stock
70000
0
D
Stock Option (Right to Buy)
3.33
2015-12-12
4
D
0
30000
0
D
2025-12-12
Common Stock
30000
0
D
Stock Option (Right to Buy)
0.75
2019-09-09
4
A
0
365500
0
A
2029-09-09
Common Stock
365500
0
D
This option was cancelled by mutual agreement between the company and the reporting person.
This option was cancelled by mutual agreement between the company and the reporting person.
This option was cancelled by mutual agreement between the company and the reporting person.
This option was cancelled by mutual agreement between the company and the reporting person.
This option was cancelled by mutual agreement between the company and the reporting person.
100% of the stock options award vests and becomes exercisable on the date of the grant date.
/s/ Richard Giles
2019-09-11